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Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 20/12/2021
Coronary artery bypass grafting is a gold standard treatment recommended to patients with coronary artery disease. The surgical intervention involves the creation of a new path, that bypasses the blocked section of the coronary artery, for ensuring the normal flow of blood. While you must have read about the procedure before, there is one thing that is not usually talked about, the type of bypass graft that is to be used. Experts specializing in coronary artery bypass surgery suggest that there are several different types of these, chosen on the basis of various different factors including the location of the obstruction, its adversity, the size of the concerned artery, and the overall health of the patient.
The long-term patency of the graft that is used during the surgery greatly determines the success of the procedure, and many experts specializing in the procedure are of the opinion that arterial grafts are way better and more durable as compared to venous grafts.
In this blog, we have discussed some of the most common grafts used in coronary artery bypass grafting, as listed by experts from the top heart hospital in Kolkata.
Internal thoracic artery - This happens to be one of the most commonly used bypass grafts, ensuring great long-term results. Usually, the lower end of the arteries is connected to the coronary artery below the obstructed portion, leaving the upper end intact. One of the best things about internal thoracic artery grafts is that they are resistant to failure at early as well as later stages. Many studies have shown that internal thoracic artery grafts come with very high success rates and hold a nearly 90 percent chance of functioning well during the early stages and continue to do so as time passes by. There are significantly low chances of recurrence of obstruction in these grafts. It is also seen that mortality rates associated with ITA grafts are very low, and so is the need for another surgery.
Radial artery - The use of radial artery graft in bypass surgery was avoided for some time owing to significantly high occlusion rates. However, the procedure was revived a few years back, improving long-term results. Thanks to the better interest stems that were prepared using new methods along with drug-based treatment with antispasmodic agents. If you talk about The perks of radial artery grafts, these are easy to prepare and mostly available. Also, such grafts are much more resistant to complications like atherosclerosis, which is quite common in venous grafts. You will be surprised to know that the graph can work wonders in the case of an arterial blockage of 70% or even higher. The graft is usually recommended to patients who are in need of two arterial grafts and are not eligible for ITA. Luckily, it can be used for elderly patients as well.
Gastroepiploic artery - The graft is commonly used to treat blockage in the right coronary artery. It is not generally used and is recommended only when the patient requires a fourth arterial graft. What is important to note here is that performing a bypass surgery will gastroepiploic graft is considerably difficult and not a favorite choice of surgeons. In order to place the graft, the doctor needs to access the patient's s abdomen, which requires a more invasive conventional approach. If we speak in terms of function, the graft is likely to give good results for quite a long term.
The type of graft that you need is decided by your doctor after thorough evaluation and consideration. To know more you can always consult an expert in the field and explore your options to choose the graft that yields the best results for you.
